Healthy Skepticism Library item: 11360

Warning: This library includes all items relevant to health product marketing that we are aware of regardless of quality. Often we do not agree with all or part of the contents.

Publication type: Journal Article

Morrow DG, Weiner M, Steinley D, Young J, Murray MD.
Patients' health literacy and experience with instructions: influence preferences for heart failure medication instructions.
J Aging Health 2007 Aug; 19:(4):575-93
http://jah.sagepub.com/cgi/content/abstract/19/4/575

Abstract:

OBJECTIVE: We developed a pharmacist-based patient education intervention to improve older adults’ adherence to chronic heart failure (CHF) medications, which included written patient-centered instructions. The study evaluated these instructions by examining whether patients preferred them to standard pharmacy instructions.

METHOD: Elders diagnosed with CHF participated in the randomized controlled trial (83 in the intervention; 153 in usual care control group). Instruction preferences were collected after 6 months of participation.

RESULTS: Patient-centered instructions were preferred for learning about adherence information (e.g., schedule) and standard instructions for learning about drug interactions. Preference for the patient-centered instructions was greater for intervention versus control participants and for participants with lower health literacy. Literacy no longer predicted preferences with patients’ cognitive abilities controlled, suggesting literacy reflected more fundamental cognitive mechanisms.

DISCUSSION: The finding that preferences varied with patients’ experience using the instructions and cognitive abilities suggests instructions should accommodate diverse patient needs and abilities.

Keywords:
Publication Types: Research Support, N.I.H., Extramural MeSH Terms: Aged Cardiovascular Agents/therapeutic use* Cognition Disorders Drug Labeling/methods* Educational Status* Female Heart Failure, Congestive/drug therapy* Humans Male Patient Compliance Patient Education/methods* Patient Satisfaction* Patient-Centered Care* Pharmacies Prescriptions, Drug United States Substances: Cardiovascular Agents

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Far too large a section of the treatment of disease is to-day controlled by the big manufacturing pharmacists, who have enslaved us in a plausible pseudo-science...
The blind faith which some men have in medicines illustrates too often the greatest of all human capacities - the capacity for self deception...
Some one will say, Is this all your science has to tell us? Is this the outcome of decades of good clinical work, of patient study of the disease, of anxious trial in such good faith of so many drugs? Give us back the childlike trust of the fathers in antimony and in the lancet rather than this cold nihilism. Not at all! Let us accept the truth, however unpleasant it may be, and with the death rate staring us in the face, let us not be deceived with vain fancies...
we need a stern, iconoclastic spirit which leads, not to nihilism, but to an active skepticism - not the passive skepticism, born of despair, but the active skepticism born of a knowledge that recognizes its limitations and knows full well that only in this attitude of mind can true progress be made.
- William Osler 1909